What does my dependent do when I die?
1. DEPENDENT SURVIVOR COVERAGE:
Dependent coverage terminates when a member’s eligibility ends for any reason other than death, or on the date when the dependent no longer meets the definition of eligible dependent, whichever occurs first. In cases of the member’s death, the Welfare Fund extends dependent coverage three (3) months following the month in which the member died.
2. COBRA
The Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), as amended, requires that the City and UFT Welfare Fund offer members, retirees and their families, the opportunity to purchase continuation of certain health and Welfare Fund benefits at 102% of the group rate (or 150% of the group rate for the 19th through the 29th months in cases of total disability) whereby the coverage would otherwise terminate. The maximum period of coverage is either 18, 29 or 36 months, depending on the reason for termination.
COBRA
The election of City (Medical/Hospital) COBRA does not enroll you in UFT Welfare Fund COBRA. A separate UFT Welfare Fund COBRA application is required.
COBRA provides continuation of Fund coverage when coverage would otherwise end because of a life event known as a “qualifying event.” Specific qualifying events are listed below. COBRA continuation coverage must be offered to each person who is a “qualified beneficiary” (QB). A qualified beneficiary is someone who will lose coverage under the Fund because of a qualifying event. Depending on the type of qualifying event, employees, their spouse/domestic partner, and dependent children of employees may be qualified beneficiaries. Qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
When am I eligible for COBRA?
Covered members are eligible for continuation under COBRA if Welfare Fund coverage was terminated due to the following qualifying events:
a. a reduction in hours of employment; or
b. the termination of employment including deferred payability and retirement.
Termination of employment includes non-covered unpaid leaves of absence of any kind and cannot be due to gross misconduct.
Spouses/domestic partners of covered members have the right to continue coverage if coverage is lost for any of the following qualifying events:
1. death of the member; or
2. termination of the member’s employment for any reason other than his or her gross misconduct; or
3. loss of coverage due to a reduction in the member’s hours of employment; or
4. divorce or legal separation from the member; or
5. termination of the domestic partnership with the member.
Dependents of members have the right to continue coverage if coverage is lost for any of the following qualifying events:
1. death of the parent-member; or
2. the termination of a parent-member’s employment for any reason other than his or her gross misconduct; or
3. loss of coverage due to a reduction in the parent-member’s hours of employment; or
4. the dependent ceases to be a “dependent child” under the Fund’s rule of eligibility.
Qualified Beneficiary (QB): Individuals entitled to COBRA coverage on their own are called qualified beneficiaries (QB). Individuals who may be qualified beneficiaries are: the covered member, the spouse/domestic partner of the covered member and the dependent child(ren) of a covered member. In order to be a QB, an individual must be covered under the UFT Welfare Fund on the day before the event that causes the loss of coverage. The Health Insurance Portability and Accountability Act (HIPAA) amended this requirement to allow a child who is born to or adopted by the covered employee, while on COBRA, to become a Qualified Beneficiary.
NOTE: Individuals covered under another employer sponsored group health plan prior to their COBRA start date are still eligible to purchase UFT Welfare Fund COBRA. However, individuals who become covered under another employer sponsored group health plan while on UFT Welfare Fund COBRA may not be eligible to continue the UFT Welfare Fund COBRA (except for the period that the new health plan excludes pre-existing conditions).
The Fund offers Medicare eligible enrollees and/or their Medicare eligible dependent(s) continuation benefits similar to COBRA if a COBRA event should occur.